Vaccinations: For some, there are no easy answers

February 4, 2014

ISHPEMING - The development of vaccines for a variety of illnesses - including measles, polio, chicken pox and the flu - is believed by many in the health and medical fields to be among the greatest achievements of the 20th century. However, a small but passionate minority insist that not only are vaccines ineffective at providing immunity to disease, but that in fact are dangerous.

In the Internet age, when an overwhelming amount of information can be gathered with a few clicks and keystrokes and sifting through what's credible and what isn't can be challenging, this minority view has gained traction especially over the past 10 to 15 years, causing some fearful parents to vaccinate their children on a different schedule than that created by the U.S. Centers for Disease Control and Prevention or even forego vaccinating their kids altogether.

Much of the information surrounding vaccines can be traced back to a 1998 study published in the respected British medical journal "The Lancet" which claimed a connection between the measles, mumps, rubella vaccine and autism spectrum disorders. The lead author of the study, Dr. Andrew Wakefield, has been charged with fraud and tied to several conflicts of interest in connection with the study's claims.

Article Photos

From left, Kris Black, pharmacist at Snyder’s Drug Stores in Ishpeming, administers the seasonal flu vaccine to Justin Marietti of Ishpeming recently. Despite parents’ concerns, health professionals stress the safety of vaccinations and the benefits of vaccinating people, particularly children and the elderly, against a wide range of illnesses. (Journal photo by Zach Jay)

But parents' fears persist. Dr. Teresa Frankovich, medical director of the Marquette County Health Department, said she and other health professionals continue to engage and encounter parents whose fears of vaccinating their children they attempt to allay by countering vaccine misinformation with education.

"It's been our job to educate parents and also to reassure them," Frankovich said. "Because it's very easy to go on the Internet and find all kinds of anecdotal, strange stories and blogs and things that relate to this, and I think for consumers it's very hard to separate out what's good scientific data from what is anecdotal or just plain misrepresentation."

Dr. Lauren Meisel, a pediatrician at Marquette General Hospital, said that the objection parents most often have about vaccines is related to fears of the autism connection. She said that her approach is to learn about parents' beliefs and broach the subject in such a way that they don't feel attacked.

"I usually want to figure out why and what their concerns are about vaccines," Meisel said. "My biggest thing is I want parents to be able to make an educated decision, and so I kind of want to know what information they're using to make their decision and what their beliefs are."

Mary Tocco, who has been the director of vaccine research and education for Michigan Opposing Mandatory Vaccines for 20 years, has radically beliefs about vaccines, but shares the same goal as Frankovich and Meisel: to educate parents, enabling them to make informed decisions.

The nonprofit MOMV bills itself as a "watch-dog group responsible for protecting the rights of parents to make vaccine decisions for their children," and seeks to maintain the option for Michigan parents to get their children a "philosophical exemption" from being vaccinated.

Tocco refers to herself as a "self-taught expert and reporter." A mother of five children, none of whom were vaccinated, she is also the founder of the website Childhood Shots, on which, along with education resources and links to various anti-vaccine research and articles, she offers such products as the book, "How to Raise a Healthy Child In Spite of Your Doctor" and a 30-minute "phone consultation" with herself, for $49.99. She maintains that she doesn't want to convince anyone to her viewpoint, just provide information.

"I am a lay person with a passionate commitment to the truth about vaccines," she said in an email. "I do not ask people to believe me; I present the other side of vaccines with medical and scientific references so that they can then make informed health decisions."

Just what does Tocco believe are the dangers of vaccinations?

"There has not been one study showing that unvaccinated children are at greater risk!" she wrote. "The current whooping cough outbreaks are a perfect example of deceptive reporting. Studies have proven that in highly vaccinated populations, outbreaks are common for the diseases vaccinated for!"

She listed several examples of recent measles and whooping cough outbreaks in the U.S., where the majority of those who contracted the illness had been vaccinated for it. This is true. But a page on the U.S. Centers for Disease Control and Prevention website dedicated to common vaccine misconceptions explains that this is can be attributed to two factors. First, no vaccine is 100 percent effective; there are a small number of people for whom the vaccine won't work, and so if they are exposed to the disease, they will contract it anyway. Second, the vast majority of the U.S. population has been vaccinated, meaning that the number of people who were vaccinated but didn't develop an immunity and were infected anyway often outnumber those few who were not vaccinated and became ill.

Tocco also supports Wakefield and his claims about dangers with the MMR vaccine. She said his study's findings have yet to be proven wrong. She said: "He will be vindicated before this is all over. He never claimed that the MMR vaccine caused autism, he and his team observed a group of children with autism who had severe gut problems.

"Further examination revealed that they were suffering with persistent measles infection, the same virus in the MMR vaccine they all received. He and his team recommended more studiesperiod! I suggest you get his book to read the full truth behind this scandal! Do not be fooled by the bias (sic) media, they are misguided. I personally have met parents who claim it was after the MMR that their child regressed into autism and I have witnessed regressive autism reversed by addressing the sick colon along with other interventions. To know the cause and address the injury and see recovery is to know the cause!"

About Wakefield's study, Meisel said: "It was a case report on 12 kids who were already not developmentally normal, and it was completely false evidence and not scientifically based. In the following 10 years after that study there have been 10 huge studies, 10 really well-respected studies on just thousands of kids that haven't shown any connection whatsoever between autism and the MMR."

While there is a risk of a bad reaction from a vaccine, the chances are extremely low. For example, the CDC lists the risk of someone unvaccinated getting pneumonia from measles at six in 100; contracting encephalitis at one in 1,000; and death at two in 1,000. By contrast, the chances of developing encaphalitis or a severe allergic reaction from the MMR vaccine is only one in one million, making the risks of not vaccinating much higher.

"If you look carefully at the research that's done around the vaccines, you realize they're actually incredibly safe," Frankovich said. "The flu vaccine we've had for decades, and it's extremely safe. It's really that matter of, the basic science of it is never as exciting and easy to sell as the hype that sometimes gets put out there."

Ironically, part of vaccines' current public image problem can be attributed to their overwhelming success.

"Vaccines in my mind are probably the top achievement in the public health realm in the last 50 years, and I think it's easy for people to forget that before vaccines, childhood death was common," Meisel said. "In a family of six kids, usually (in) most families at least one or two died before the age of 12 due to a vaccine-preventable illness. And now we don't see it, at all. I think it's easy for (people) to forget, but if we're not vaccinating, these diseases could come back, and that could become the norm again."

Frankovich said that parents looking to get detailed, specific, reliable information on specific vaccines, including their effectiveness and potential side effects, can go to the Centers for Disease Control and Prevention website. For parents looking for info specifically for their children, she recommended the American Academy of Pediatrics.